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Who’s rating doctors on RateMDs? The invisible hand of ‘reputation management’

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This is an excerpt from Second Opinion, a weekly roundup of eclectic and under-the-radar health and medical science news emailed to subscribers every Saturday morning. If you haven’t subscribed yet, you can do that by clicking here.

Did that doctor pay to hide some bad reviews on RateMDs, the online physician rating system? You wouldn’t know.

Nor would you know if a doctor hired a reputation management service to boost the volume of positive reviews.

Online reputation management is an emerging industry with companies offering a variety of services to professionals who find themselves ranked on rating sites with no ability to opt out and with no control over the anonymous comments that can affect their reputation.

I feel this is akin to  cyberbullying .– Dr. Sukhbir  Singh, gynecologist, The Ottawa Hospital

The fact that those reputation management tools exist came as a shock to Dr. Sukhbir Singh, a gynecologist at The Ottawa Hospital.

Singh was already grappling with a negative review posted on his RateMDs page — a posting he discovered last weekend after an anonymous person claimed he had harmed them with a procedure that he doesn’t do.

He quickly responded on the site, advising the person to speak to the hospital about their concerns,

Then, just as suddenly, the posting vanished.

« This is crazy. None of this makes sense to me, » he said. « I feel this is akin to cyberbullying. »

In the middle of all of that a sales representative from RateMDs contacted him offering « reputation management tools » for a fee. The service includes the ability to keep up to three comments hidden from public view.

« That just made me sick to my stomach, » he said. « It doesn’t seem that in a public health-care system that I should be marketing myself, that I should be protecting my reputation and paying an independent private company to do that work. »

RateMDs offers doctors two special plans to enhance their presence on the site. The « Promoted » package costs $179 US per month and includes banner ads that will appear on competing doctor’s pages.

RateMDs online physician rating site sells advertising packages to doctors which allows them to pay a fee and hide some unfavourable comments. (Daniel Rofusz/CBC News)

And for $359 US per month the doctor can buy the « Promoted plus » option. Both packages allow doctors to hide up to three unfavourable comments — a feature called « Ratings Manager. »

But if a doctor stops paying, those unfavourable ratings will reappear.

« The reviews a provider designates with the Ratings Manager are not permanently removed and their numerical scores remain as part of the calculation of a provider’s overall rating, » said Chris Goodridge, chief investment officer of VerticalScope Inc., the parent company of Toronto-based RateMDs. (Torstar Corp, publisher of the Toronto Star, purchased a 56 per cent ownership in VerticalScope in 2015.)

« If a user unsubscribes from the Promoted or Promoted Plus plans, he or she will no longer receive the benefits associated with that subscription, » Goodridge said via email. 

« You’re held a little bit to ransom because the second you stop paying that $200 per month, those hidden reviews come back online, » said Ryan Forman, who runs a company called GlowingMDs that helps doctors manage their RateMDs profiles.

Reclaiming reputations

Forman’s company advertises its service to doctors with the line: « Reclaim your reputation. »

For a monthly fee of $229 plus HST the company provides a ratings template that doctors offer to patients to complete after an appointment.

« We then take all of those reviews, good or bad, from the doctor, and we then post it to RateMDs in effect on the doctor’s behalf. »

A reputation management company advertises service to physicians to boost positive patient testimonials on RateMDs online doctor rating site. (Daniel Rofusz/CBC News)

« We’re not able to remove any negative reviews but what we can do is post legitimate reviews that come through the doctor and hopefully improve their RateMDs profile, » said Forman.

Over at RateMDs, Goodridge said he knows that companies are selling reputation management services that target the online site.

« We’re certainly aware that there are a number of companies that support health care providers in soliciting patient reviews and in assisting with posting those reviews, » wrote Goodridge, adding that RateMDs has a system to disallow testimonials from suspicious sources.  

« RateMDs.com utilizes a variety of proprietary methods to identify and remove programmatically-generated reviews or reviews originating from suspicious sources. »

Software circumvents filters

But Forman said RateMDs filters have not prevented his company from posting multiple patient testimonials for a single doctor.

« We have had experience where they have picked up where we are putting more than one review for a doctor from the same location but the truth is our software circumvents that, » said Forman, adding he simply tweaks his software to get around the RateMDs filters.

So could anyone get the software and start posting whatever they wanted as many times as they wanted?

« Yes, I think if they were tech-savvy they probably could, » Forman said. » It’s not software that we developed, it’s software that’s out there on the internet so, yeah, they could definitely do it on their own. »

RateMDs is a free and open forum. That means anyone can say anything about any doctor. Just write a comment, click on each of the four rating stars and hit « Rate this doctor. » The site does not ask for a name, email address or phone number.

The doctor has no control over whether he or she appears on the site and there is no way to remove their page once it’s been posted.

A study published in the Journal of Medical Internet Research found that more than half of Canada’s physicians have been rated on the site.

« Overall, physicians are rated positively, » said study author Dr. Jessica Lui, a clinical investigator at the University of Toronto. « We did find there were differences in the likelihood of receiving a positive rating depending on what type of medicine you practiced. »

Misconduct decisions not visible 

But how useful are those ratings for patients especially if there are ways for doctors to boost their positive ratings?

And right now RateMDs does not post any warnings about physicians who have been disciplined by the medical regulatory colleges.

« If a provider has active or past disciplinary actions on their file they are not visible on their RateMDs.com profiles, » Goodridge wrote.

The remedies do not entirely correspond to the challenge.– Chantal Bernier, privacy and cybersecurity counsel, Dentons Canada LLP

The result? Doctors who have committed professional misconduct including sexual abuse of patients can still have glowing reviews on RateMDs.

« Providing transparency on disciplinary actions is a feature we continue to pursue on behalf of our audience, » wrote Goodridge. « At the moment, the limited availability of this data from the disparate colleges does not make this practical. RateMDs.com hopes to add this information in the near future by partnering with regulatory colleges if they are willing. »

There is also little transparency when it comes to anonymous accusations posted on RateMDs. Several doctors told CBC News about bad experiences including malicious postings from disgruntled employees.

And when patients do post negative reviews, the doctors pointed out that they can’t tell their side of the story without breaking patient confidentiality.

Forman started GlowingMDs after seeing some of those problems emerge in the medical clinics he manages.

« There’s definitely a need for the service, » Forman said. « Their hands are tied in terms of what they can say and do on RateMDs »

Thorny issues

Being rated without your consent can now happen to anyone. Doctors, lawyers, dog walkers — there is nothing preventing a company from setting up an online rating site and publishing anonymous reviews in any field — comments that will circulate on the internet forever.

« There is, I think, a very real issue that has, in a way, run away on us because we do not have the laws that specifically address these situations, » said Chantal Bernier, former federal privacy commissioner, now a privacy and cybersecurity counsel at Dentons Canada LLP.

« The thorny issues it presents is the reconciliation between the right to information, the obligation of accountability on one side and privacy and reputation on the other. »

Bernier said there is a need to examine the legislative tools that will be required to manage those competing ethical issues.

« Right now the remedies do not entirely correspond to the challenge. »

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Nostalgia and much more with Starburst XXXtreme

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Get a taste of adventure with Starburst XXXtreme based on the legendary NetEnt Game. The nostalgic themes are sure to capture fans of the classic version as they get treated to higher intensity, better visuals, and features. The most significant element of the game is its volatility. Patience will not be an essential virtue considering the insane gameplay, and there is a lot of win potential involved. It retains the original makeup of the previous game while adding a healthy dose of adrenaline. 

Starburst Visuals and Symbols

The game is definitely more conspicuous than before. The setting happens over a 5-reel, 3-row game grid with nine fixed win lines, which function if a succession from the left to the right reel is present. Only those players that that attain the highest win per bet line are paid. From a visual standpoint, the Starburst XXXtreme slots illustrates lightning effects behind the reels, which is not surprising as it is inherited from the original version. Available themes include Classic, Jewels, and Space. The game is also available in both desktop and mobile versions, which is advantageous for players considering the global pandemic. According to Techguide, American gamers are increasingly having more engaging gaming experiences to socialize to fill the gap of in-person interaction. Starburst XXXtreme allows them to fill the social void at a time when there is so much time to be had indoors. 

Starburst XXXTreme Features

Players get to alternate on three features which are Starburst Wilds, XXXtreme Spins, and Random Wilds. The first appears on reels 2,3, or 4. When these land, they expand to cover all positions while also calculating the wins. They are also locked for a respin. If a new one hits, it also becomes locked while awarding another respin. Starburst XXXtreme offers a choice between two scenarios for a higher stake. In one scenario with a ten times stake, the Starburst Wild is set on random on reels 2,3, or 4, and a multiplier starts the respin. The second scenario, which has a 95 times stake, starts with two guaranteed starburst wilds on reels 2,3, or 4. it also plays out using respin game sequence and features. The game also increases the potential with the Random Wilds feature to add Starburst Wilds to a vacant reel at the end of a spin. Every Starburst Wild gives a random multiplier with potential wins of x2, x3, x5, x10, x25, x50, x100, or even x150.

The new feature is sure to be a big hit with the gaming market as online gambling has shown significant growth during the lockdown. AdAge indicates the current casino customer base is an estimated one in five Americans, so Starburst XXXtreme’s additional features will achieve considerable popularity. 

What We Think About The Game

The gambling market has continued to diversify post-pandemic, so it is one of the most opportune times to release an online casino-based game. Thankfully Starburst XXXtreme features eye-catching visuals, including the jewels and space themes. These attract audience participation and make the gameplay inviting. The game also has a nostalgic edge. The previous NetEnt iteration featured similar visuals and gameplay, so the audience has some familiarity with it. The producers have revamped this version by tweaking the features to improve the volatility and engagement. 

That is characterized by the potential win cap of 200,000 times the bet. Starburst XXXtreme does not just give betting alternatives for players that want to go big. The increase of multipliers also provides a great experience. If the respins in the previous version were great, knowing that multipliers can go hundreds of times overtakes the game to a new level. 

Players should get excited about this offering. All of the features can be triggered within a single spin. Whether one plays the standard game or takes the XXXtreme spin route, it is possible to activate all of the features. Of course, the potential 200,000 times potential is a huge carrot. However, the bet size is probably going to be restricted and vary depending on the casino. It is also worth pointing out that a malfunction during the gameplay will void all of the payouts and progress. Overall, the game itself has been designed to provide a capped win of 200,000 times the original bet. 

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Anglais

‘We’re back’: Montreal festival promoters happy to return but looking to next year

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In downtown Montreal, it’s festival season.

In the city’s entertainment district, a musical act was conducting a sound check on stage Friday evening — the second day of the French-language version of the renowned Just For Laughs comedy festival. Tickets for many of the festival’s free outdoor shows — limited by COVID-19 regulations — were sold out.

Two blocks away, more than 100 people were watching an acoustic performance by the Isaac Neto Trio — part of the last weekend of the Festival International Nuits d’Afrique, a celebration of music from the African continent and the African diaspora.

With COVID-19 restrictions continuing to limit capacity, festival organizers say they’re glad to be back but looking forward to next year when they hope border restrictions and capacity limits won’t affect their plans.

Charles Décarie, Just For Laughs’ CEO and president, said this is a “transition year.”

“Even though we have major constraints from the public health group in Montreal, we’ve managed to design a festival that can navigate through those constraints,” Décarie said.

The French-language Juste pour rire festival began on July 15 and is followed by the English-language festival until July 31.

When planning began in February and March, Décarie said, organizers came up with a variety of scenarios for different crowd sizes, ranging from no spectators to 50 per cent of usual capacity.

“You’ve got to build scenarios,” he said. “You do have to plan a little bit more than usual because you have to have alternatives.”

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MELS new major movie studio to be built in Montreal

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MONTREAL — MELS Studios will build a new film studio in Montreal, filling some of the gap in supply to meet the demand of Hollywood productions.

MELS president Martin Carrier said on Friday that MELS 4 studio construction will begin « as soon as possible », either in the fall or winter of next year. The studio could host productions as early as spring 2023.

The total investment for the project is $76 million, with the Quebec government contributing a $25 million loan. The project will create 110 jobs, according to the company.

The TVA Group subsidiary’s project will enable it to stand out « even more » internationally, according to Quebecor president and CEO Pierre Karl Péladeau. In the past, MELS Studios has hosted several major productions, including chapters of the X-Men franchise. The next Transformers movie is shooting this summer in Montreal.

Péladeau insisted that local cultural productions would also benefit from the new facility, adding that the studio ensures foreign revenues and to showcase talent and maintain an industry of Quebec producers.

STUDIO SHORTAGE

The film industry is cramped in Montreal.

According to a report published last May by the Bureau du cinéma et de la télévision du Québec (BCTQ), there is a shortage of nearly 400,000 square feet of studio space.

With the addition of MELS 4, which will be 160,000 square feet, the company is filling part of the gap.

Carrier admitted that he has had to turn down contracts because of the lack of space, representing missed opportunities of « tens of millions of dollars, not only for MELS, but also for the Quebec economy. »

« Montreal’s expertise is in high demand, » said Montreal Mayor Valérie Plante, who was present at the announcement.

She said she received great testimonials from « Netflix, Disney, HBO and company » during an economic mission to Los Angeles in 2019.

« What stands out is that they love Montreal because of its expertise, knowledge and beauty. We need more space, like MELS 4, » she said.

There is still not enough capacity in Quebec, acknowledged Minister of Finance, the Economy and Innovation Eric Girard.

« It is certain that the government is concerned about fairness and balance, so if other requests come in, we will study them with the same seriousness as we have studied this one, » he said.

Grandé Studios is the second-largest player in the industry. Last May, the company said it had expansion plans that should begin in 2022. Investissement Québec and Bell are minority shareholders in the company.

For its part, MELS will have 400,000 square feet of production space once MELS 4 is completed. The company employs 450 people in Quebec and offers a range of services including studio and equipment rentals, image and sound postproduction, visual effects and a virtual production platform.

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